Efficacy and complications of morphine infusions in postoperative paediatric patients
Child; Female; Humans; Male; Pain; Analgesics; Follow-Up Studies; Confidence Intervals; Incidence; Acute Disease; adolescent; Preschool; infant; retrospective studies; Infusions; Intravenous; Opioid/administration & dosage/adverse effects/therapeutic use; Morphine/administration & dosage/adverse effects/therapeutic use; Postoperative/prevention & control; Respiration/drug effects; Akathisia; Analgesia/nursing; Anesthesia Recovery Period; Anoxemia/chemically induced; Arousal/drug effects; Drug-Induced/etiology; Postoperative Nausea and Vomiting/chemically induced; Pruritus/chemically induced; Urinary Retention/chemically induced
The aim of the study was to evaluate the efficacy and the incidence of clinically significant adverse drug reactions (ADRs) in paediatric patients receiving continuous intravenous morphine infusions for acute postoperative pain. Definitions were established for ADRs and data were collected in an immediately retrospective fashion for a maximum of 72 h in 110 patients >/=5 three months of age (0.3-16.7 years) receiving morphine infusions and admitted to a general ward over a three month convenience sampling period. Inadequate analgesia occurred in 65.5% of patients during the first 24 h of therapy and occurred most frequently in patients with infusion rates of 20 microg.kg-1.h-1 or less. Nausea/vomiting was the most commonly experienced ADR (42.5%). The incidence of respiratory depression was 0% (95% CI=0-3.3%). Other ADRs included: urinary retention (13.5%), pruritus (12.7%), dysphoria (7.3%), hypoxaemia (4.5%), discontinuation of morphine for treatment of an ADR (3.6%), and difficulty in arousal (0.9%). The most common ADRs associated with morphine infusions were inadequate analgesia (in the first 24 h) and nausea/vomiting. There were no cases of respiratory depression. Methods of avoiding initial inadequate analgesia and treating nausea and vomiting associated with morphine infusions are needed.
1999
Esmail Z; Montgomery C; Courtrn C; Hamilton D; Kestle J
Paediatric Anaesthesia
1999
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1046/j.1460-9592.1999.00384.x" target="_blank" rel="noreferrer">10.1046/j.1460-9592.1999.00384.x</a>
High-dose oral morphine in cancer pain management: a report of twelve cases
Female; Male; Pain; Analgesics; Aged; Fatal Outcome; Non-U.S. Gov't; Human; Case Report; Support; Intractable/drug therapy/etiology; Middle Age; Morphine/administration & dosage/adverse effects/therapeutic use; Neoplasms/complications; Opioid/administration & dosage/adverse effects/therapeutic; use
We present 12 case reports from patients treated with more than 600 mg of morphine per day. We found no "opioid-nonresponsive pain" under treatment with a combination of morphine and nonopioids, supplemented with coanalgesics where appropriate. Side effects of morphine therapy were controlled with adjuvant drugs. Serious adverse effects were not observed. Episodes of break-through pain, dysphagia, and dyspnea caused by far advanced cancer disease were seen frequently.
1996
Radbruch L; Grond S; Zech DJ; Bischoff A
Journal of Clinical Anesthesia
1996
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/0952-8180(95)00201-4" target="_blank" rel="noreferrer">10.1016/0952-8180(95)00201-4</a>
Disappearance of morphine-induced hyperalgesia after discontinuing or substituting morphine with other opioid agonists
Child; Female; Humans; Male; Adult; Analgesics; Aged; Middle Aged; Pain/complications/drug therapy; Neoplasms/complications; Delayed-Action Preparations; Methadone/therapeutic use; Narcotics/therapeutic use; Hyperalgesia/chemically induced/psychology; Meperidine/analogs & derivatives/therapeutic use; Morphine/administration & dosage/adverse effects/therapeutic use; Myoclonus/chemically induced; Opioid/therapeutic use; Sufentanil/therapeutic use
Hyperalgesia and allodynia in 4 cancer patients treated with morphine disappeared after discontinuing or substituting morphine with other opioid agonists. The first case describes a young female who developed hyperalgesia and myoclonus during intravenous morphine infusion. The hyperalgesia and myoclonus disappeared when the morphine administration was discontinued and she felt comfortable on small and sporadic oral doses of methadone. The second case describes hyperalgesia occurring after a small dose of sustained-release morphine which disappeared after alternative use of oral ketobemidone. The third case describes hyperalgesia following high doses of intramuscular morphine which disappeared after alternative use of continuous subcutaneous infusion of sufentanil. The fourth case describes a boy developing hyperalgesia after high doses of oral and intramuscular morphine. The hyperalgesia disappeared after discontinuing morphine administration but withdrawal symptoms developed due to too small doses of methadone. Possible mechanisms of morphine-induced hyperalgesia are discussed.
1994
Sjogren P; Jensen NH; Jensen TS
Pain
1994
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/0304-3959(94)90084-1" target="_blank" rel="noreferrer">10.1016/0304-3959(94)90084-1</a>